Provider Demographics
NPI:1679918270
Name:A NEW DIRECTION COUNSELING AND SUPPORT SERVICES LLC
Entity Type:Organization
Organization Name:A NEW DIRECTION COUNSELING AND SUPPORT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LLC MEMBER
Authorized Official - Prefix:MISS
Authorized Official - First Name:LAQUANDRA
Authorized Official - Middle Name:C
Authorized Official - Last Name:MUOMAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-421-9409
Mailing Address - Street 1:3675 CRESTWOOD PKWY NW
Mailing Address - Street 2:4TH FLOOR, SUITE# 401
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-1805
Mailing Address - Country:US
Mailing Address - Phone:404-421-9409
Mailing Address - Fax:
Practice Address - Street 1:3675 CRESTWOOD PKWY NW
Practice Address - Street 2:4TH FLOOR, SUITE# 401
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-1805
Practice Address - Country:US
Practice Address - Phone:404-421-9409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0556692101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty